What is Telehealth and How Does it Work?

Telehealth is the use of technology, particularly communication technology and digital information via mobile devices and computers, to access different healthcare services from a distance. Both doctors and patients use telehealth, which has many different applications.

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Modern technology has made many things in life more accessible and convenient, and healthcare is certainly one of them. According to the American Hospital Association, an estimated 76 percent of U.S. hospitals have fully or partially implemented a computerized telehealth visit system as of 2017, and the recent COVID-19 pandemic has only caused those numbers to continue to rise. The Medicaid and Medicare program in nearly every state has adopted some type of coverage for telehealth services, and many commercial insurance companies are following the same route. Telehealth certainly seems to be the direction our healthcare system is moving, but what is telehealth and how does it work?

What is telehealth?

HealthIT.gov defines telehealth as “the utilization of electronic information and telecommunications technologies to support and promote long-distance clinical healthcare, patient and professional health education, public health, and health administration.” What does that mean in simpler terms? Telehealth is the use of technology, particularly communication technology and digital information via mobile devices and computers, to access different healthcare services from a distance; i.e., a virtual visit versus an in-person visit. Both doctors and patients use telehealth technologies, which has many different applications. 

Regardless of how it is used, there are several main goals of telehealth:

  • Increase the accessibility of healthcare and health resources for people who live in isolated or rural areas
  • Improve access to medical specialists and specialty care
  • Allow for remote patient monitoring for those with certain conditions
  • Provide support so that patients are better able to manage their own healthcare
  • Improve the availability and convenience of healthcare services for people who have mobility constraints, do not have reliable transportation, or have limited time to access healthcare services
  • Improve the level of coordination and communication between the patient and their specialty or primary care team

Telehealth can be used in many different ways to improve patient care. For example, a person with high blood pressure could use their phone or mobile device to access and upload blood pressure readings, food logs, and a medication list for review by their doctor or nurse, or they could watch a video about how sodium increases blood pressure. They might access an online patient portal to receive the latest results of their blood work, receive email or text reminders about checking their blood pressure, or schedule a video visit with their doctor online. These are just a few of the many different ways that telehealth can be used.

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What is the difference between telehealth and telemedicine?

The terms telehealth and telemedicine are often used interchangeably, but the phrases do not mean the same thing, as there are important differences between telehealth and telemedicine. While telehealth is defined by HealthIT.gov as “the utilization of electronic information and telecommunications technologies to support and promote long-distance clinical healthcare, patient and professional health education, public health, and health administration,” telemedicine is defined as “healing from a distance” and encompasses the many different ways your healthcare provider can assist you without a visit to their office. Telemedicine is a service and is included under the term telehealth, which includes both the clinical aspects of telemedicine benefits as well as health education, appointment scheduling, and other functions. 

How does telehealth work?

The use of telehealth is predominantly through mobile devices or computers. The type of telehealth services accessed by a patient will depend on their specific circumstances, needs, and medical conditions. Below are examples of available telehealth services.

Virtual appointments

Virtual appointments are perhaps the telehealth service that most people are aware of, especially in the midst of the COVID-19 pandemic. Some hospitals and clinics offer virtual appointments that allow a patient to speak to their healthcare professional through online videoconferencing. Virtual appointments are most commonly used for minor illnesses or issues, such as cold,  skin condition, aches and pains associated with a minor injury, and other non-urgent care problems that may not require a physical exam. The virtual appointment allows your healthcare professional to see you and view any visible symptoms, as well as discuss the problems you are experiencing. Through the program, your doctor or prescribing physician is able to prescribe medication, suggest remedies that can be provided at home, or recommend an in-person appointment.

Doctor-to-doctor communication

Telehealth also facilitates increased ease of doctor-to-doctor communication through virtual consultations. Doctors and healthcare professionals using telehealth can send medical records, test results, imaging, exam notes, and other materials to other doctors through telehealth services in real-time in order to get their opinion on a case without having to schedule an in-person meeting or mail or fax medical records. This helps the patient by reducing the need for travel and limiting wait times for a specialist’s opinion. 

Personal health apps

There is a huge variety of apps on the market today that can help people monitor their own health and store health and medical information in one central location. These apps include programs that allow you to track the number of calories you eat each day, count the number of steps you’ve taken or the amount of time you’ve exercised, store personal health information, schedule reminders to take your medication, and record vital health signs. Patients often find these apps helpful because all of the information they may need to access is available at their fingertips, rather than hassling with keeping and organizing paper records.

Patient portal

These days, many hospitals and healthcare systems have online patient care portals as a secure alternative to email. Patient portals allow patients to access all of their medical information from this particular hospital or healthcare system in one place, including test results, visit summaries, and more. Patients can also use the portal to request a prescription refill, schedule an appointment with their doctor, or communicate online with a doctor or nurse. If your portal is part of a larger healthcare system, all of the specialists that you see within that healthcare system will have access to your information in one central location, helping to avoid oversight or gaps in your medical history. 

Remote monitoring

Taking regular trips to the doctor’s office to be monitored for existing health conditions can be a substantial investment of time and money that some people simply cannot afford to make. Remote monitoring allows your healthcare team to keep track of your health from a distance using technology. For example, a person with diabetes could use a mobile app to upload information about their blood glucose readings each day, which would then be reviewed by their healthcare team. Some medical devices connect and sync information automatically via Bluetooth, including some blood pressure monitoring systems, blood glucose monitors, or lung function monitoring systems. Other wearable devices can also sync automatically to a mobile app or computer program, allowing your doctor to review your physical activity, sleep patterns, gait, brain activity, and more. This allows your doctor to find patterns in your health without requiring daily or weekly office visits to perform testing. Remote monitoring can also be used for people with dementia and elderly people who are at an increased risk of falls, as the devices can record and transmit fall information. 

Personal health records

Personal health records differ from personal health apps because they consolidate all of your medical records in one place for easy access, rather than helping you calculate health quantifiers throughout the day, such as your pulse or calorie intake. People are responsible for the control and maintenance of their personal health record, which can be accessed on a tablet, smartphone, or computer. Personal health records store information like medications you may be taking, food or drug allergies, current medical issues, medical history, and contact information for your healthcare professionals. 

What are the benefits of telehealth?

The major benefits of telehealth include the potential to improve the quality of healthcare and healthcare delivery that people receive, as well as the possibility of making healthcare accessible to more people, especially when it comes to mental health care. In many cases, telehealth can help make healthcare more efficient, improve coordination between healthcare professionals, and allow patients to receive adequate healthcare closer to their homes. Because telehealth allows physicians to virtually monitor their patients through phone-based support and telemonitoring, physicians are able to regularly check in on their patients’ vital signs and health statistics. Doing so can help lower the risk of worsening illness, hospitalization, and death for patients with serious medical issues.

What are the limitations of telehealth?

While there are many benefits to telehealth, the service also has its limitations. In many cases, telehealth can lead to better coordinated care, but it can also contribute to standard information technology issues and fragmented healthcare that may not be encountered by human services in in-person health centers, which can cause an inappropriate use of medications, gaps in care, overuse of medical care, or unnecessary medical care. Telehealth is also currently limited by outside factors, including the varying reimbursements for telehealth services between insurance companies and different states. People without regular internet access or mobile devices that support telehealth are often the people who would benefit most from telehealth services, but they may not have access due to these limiting factors. 

References: 

https://www.aha.org/factsheet/telehealth 

https://www.healthit.gov/topic/health-it-initiatives/telemedicine-and-telehealth 

https://www.who.int/goe/publications/goe_telemedicine_2010.pdf 

https://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/telehealth/art-20044878 

https://www.webmd.com/lung/how-does-telemedicine-work#1 

https://www.health.com/mind-body/what-is-telemedicine-telehealth

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